Hospital Readmissions Program Accuracy and Accountability Act of 2014

H.R. 1201, Training Tomorrows Doctors Today Act H.R. 1250, the Medicare Audit Improvement Act H.R. 1180/S. 577, The Resident Physician Shortage Reduction Act of 2013 H.R. 1920, the DSH Reduction Relief Act S. 2728, Community-Based Medical Education Act of 2014 S. 2658, The Accelerating Biomedical Research Act S. 2501, the Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 H.R. 5339, The Expanding Opportunities for Recovery Act H.R. 5110, SAVE Medicare Home Health Act of 2014 H.R. 5458, Building a Healthcare Workforce of the Future Act H.R. 5481, The Flexibility in Health IT Reporting (Flex-IT) Act OMHA-1401-NC, Medicare Program; Administrative Law Judge Hearing Program for Medicare Claim Appeals, Request for Information CMS-3819-P, Medicare and Medicaid Program: Conditions of Participation for Home Health Agencies; Proposed Rule

Client expense: $312,120 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961 Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins(R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it. Discussed with the VA the implementation of the Act. Discussed with HHS the use of electronically-readable smart cards by hospitals and health systems; Discussed with HHS meaningful use program, certification program for EHRs and interoperability of health information.

Client expense: $5,590,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE, Veterans Affairs, Dept of (VA)

H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

Client expense: $90,000 · Firm income: Not reported

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

Client expense: Not reported · Firm income: $70,000

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

S.183, Hospital Payment Fairness Act of 2013, Issues pertaining to sunsetting national budget neutrality for the hospital wage index. H.R. 2053, S. 1012, Medicare Hospital Wage Index Equity Act, Issues pertaining to changing the national budget neutrality for the hospital wage index to a state neutrality. H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1250, S. 1012, Medicare Audit Improvement Act of 2013, Issues pertaining to RAC audits for hospitals. H.R. 1920, S. 1555, DSH Reduction Relief Act of 2013, Issues regarding delaying implementation of DSH cuts. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2728, Community-Based Medical Education Act of 2014, Issues relating to concerns about reductions to IME and other items. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions H.R. 647, Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014), provisions relating to Misvalued Codes S. 313, Achieving a Better Life Experience Act of 2013 (ABLE Act of 2013), provisions relating to Misvalued Codes H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 4282, Creating Access to Residency Education Act of 2014, all provisions H.R. 4843, Native Contract and Rate Expenditure Act of 2014 (Native CARE Act of 2014), all provisions H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes, all provisions H.R. 4998, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions S. 2552, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions H.R. 5723, Ensuring Access to Primary Care for Women & Children Act, all provisions S. 2694, Ensuring Access to Primary Care for Women & Children Act, all provisions H.R. 5780, Protecting the Integrity of Medicare Act (PIMA) of 2014, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to coding and pricing issues Medicare program: SGR Repeal Medicare program: Independent Payment Advisory Board (IPAB) Repeal Medicare program: Medicare Patient Empowerment Act Medicare program: Graduate Medical Education Medicare program: ICD-10 Repeal Medicare program: Overlapping Medicare incentive programs Medicare program: HIPAA including ICD-10 Medicare program: Electronic Health Records (EHR) - Meaningful Use Medicare program: EHR Certification Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Laboratory Developed Tests Medicare program: Alternative Payment Models/quality performance measures Medicare program: Physician payment and delivery reform issues Medicare program: Hospital short stay Medicare program: Medicare funding for quality measure development Medicare program: Value-Based Modifiers Medicare program: Global Surgical Codes Medicare program: In-Office Ancillary Services Exception Medicare program: RUC - Misvalued and Care Coordination Codes Medicare program: Diabetes Medicare program: Recovery Audit Contractors Medicare program: Program Integrity - Meaningful Use Audits Medicare program: Program Integrity - Modifiers Medicare program: Program Integrity - Electronic Health Records Medicare and Medicaid programs: Coverage of lung cancer screening for high-risk patients

Client expense: $4,390,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Advocated for fairness in Medicare Advantage Stars Quality measurements; opposed cuts to Medicare Advantage rates; S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014; H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act.

Client expense: $430,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, issues relating to Medicare Advantage star ratings; S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, issues relating to Medicare Advantage star ratings; Implementation of the Patient Protection and Affordable Care Act (PL 111-148), issues relating to Medicare Advantage and Medicare Advantage star rating, Medicare sustainable growth rate, doc fix, managed care for dual eligible individuals, insurer fees, Medicare reimbursement rates, and Independent Payment Advisory Board (IPAB); Extension of ICD-10 transition deadline.

Client expense: Not reported · Firm income: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.647 - Achieving a Better Life Experience (ABLE) Act of 2014 H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1250 - Medicare Audit Improvement Act 2013 H.R.1487 - Improved Health Care Lower Cost Act of 2013 H.R.1838 - Enhanced Access to Medicaid Services H.R.2810 - Medicare Patient Access and Quality Improvement Act of 2013 H.R.3144 - Fairness for Beneficiaries Act of 2013 H.R.4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.5460 - Medicare Ambulance Access, Fraud Prevention and Reform Act of 2014 S.313 - Achieving a Better Life Experience (ABLE) Act of 2014 S.351 - Protecting Seniors' Access to Medicare Act of 2013 S.569 - Improving Access to Medicare Coverage Act of 2013 S.755 - Enhanced Access to Medicaid Services S.1012 - Medicare Audit Improvement Act 2013 S.1871 - SGR Repeal and Medicare Beneficiary Access of 2013 S.2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2240 - Medicare Choices Empowerment and Protection Act S.2501 - Hospital Readmission Accuracy and Accountability Act

Client expense: $228,645 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.36 - Health Care Safety Net Enhancement Act of 2013 H.R.235 - Veteran Emergency Medical Technician Support Act of 2013 H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.647 - Achieving a Better Life Experience (ABLE) Act of 2014 H.R.809 - Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R.1098 - Traumatic Brain Injury Reauthorization Act of 2013 H.R.1201 - Training Tomorrow's Doctors Today Act H.R.1263 - Excellence in Mental Health Act H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1180 - Resident Physician Shortage Reduction Act of 2013 H.R.1487 - Improved Health Care Lower Cost Act of 2013 H.R.1838 - Enhanced Access to Medicaid Services H.R.2186 - Verifying Authority and Legality In Drug Compounding Act of 2013 H.R.2900 - Offering Patients True Individualized Options Now (Option Act of 2013) H.R.2300 - Empowering Patients First Act of 2013 H.R.2810 - Medicare Patient Access and Quality Improvement Act of 2013 H.R.3392 - Patient Safety and Drug Abuse Prevention Act H.R.3528 - National All Schedules Prescription Electronic Reporting Reauthorization Act of 2013 H.R.3548 - Improving Trauma Care Act of 2013 H.R.3717 - Helping Families in Mental Health Crisis Act of 2013 H.R.4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.4080 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.4106 - Saving Lives, Saving Costs Act H.R.4169 - Stop Overdose Stat Act H.R.4574 - Strengthening Mental Health in Our Communities Act of 2014 H.R.5460 - Medicare Ambulance Access, Fraud Prevention and Reform Act of 2014 S.44 - Medical Care Access Protection (MCAP) Act of 2013 S.264 - Excellence in Mental Health Act S.265 - Community-Based Mental Health Infrastructure Improvements Act S.313 - Achieving a Better Life Experience (ABLE) Act of 2014 S.328 - Strengthening Rural Access to Emergency Services Act S.351 - Protecting Seniors' Access to Medicare Act of 2013 S.569 - Improving Access to Medicare Coverage Act of 2013 S.577 - Resident Physician Shortage Reduction Act of 2013 S.755 - Enhanced Access to Medicaid Services S.961 - Health Care Safety Net Enhancement Act of 2013 S.1871 - SGR Repeal and Medicare Beneficiary Access of 2013 S.2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2240 - Medicare Choices Empowerment and Protection Act S.2400 - Field EMS Innovation Act S.2405 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.2406 - Improving Trauma Care Act of 2014 S.2501 - Hospital Readmission Accuracy and Accountability Act S.2539 - Traumatic Brain Injury Reauthorization Act of 2014 S.2755 - Overdose Prevention Act

Client expense: $228,645 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

Client expense: Not reported · Firm income: $30,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 83: Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Medicare Audit Improvement Act of 2013 (H.R. 1250) Resident Physician Shortage Reduction Act (S. 577/H.R. 1180) Protecting Seniors Access to Medicare Act of 2013 (H.R. 351 and S. 351) The DSH Reduction Relief Act of 2013 (H.R. 1920) Rural Hospital Access Act (H.R. 1787) Rural Hospital Fairness Act (H.R. 2578) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188)/ Hospital Readmissions Program Accuracy and Accountability Act of 2014 (S. 2501) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Flexibility in Health IT Reporting Act (HR 5481) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Severe sepsis protocols Medicare and Medicaid Recovery Audit Contractor (RAC) Programs Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, inpatient coding offset, hospital outpatient department (HOPD) evaluation and management (E/M) services, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Hospital and health system pricing transparency Clinical quality measures and electronic clinical quality measures FY 2014 Inpatient Prospective Payment System Final Rule (CMS-1599-F) - Two-Midnight Policy FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare physician payment; Medicare coverage; Medicare hospital payment; physician and hospital quality; medical liability reform; electronic health record incentive program; clinical data registries; graduate medical education; health care quality; medical imaging and prior authorization; in-office ancillary services exception. HR 2914, Promoting Integrity in Medicare Act; SGR Repeal and Beneficiary Access Improvement Act; HR 4015/S 2000, SGR Repeal and Medicare Provider Payment Modernization Act; S 2501, Hospital Readmission Accuracy and Accountability Act; S 1932/HR 3890, Better Care, Lower Cost Act; Facilitating Participation in Clinical Data Registries Act; IMPACT Act; S 2552, Medicare Advantage Participant Bill of Rights Act; HR 4282, CARE Act; HR 4930, Advancing Care for Exceptional Kids Act; S 961/HR 36, Health Care Safety Net Enhancement Act; HR 5215, to provide for recommendations for the development and use of clinical data registries; HR 5481, FLEX-IT Act; HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act; HR 4857, Ensuring Equal Access to Treatments Act; S 1758, Quality Data, Quality Healthcare Act; HR 4418, Expanding the Availability of Medicare Data Act; Hospital Improvements for Payment (HIP) Act of 2014; Protecting Integrity in Medicare Act of 2014 (PIMA); HR 647, ABLE Act; S 2461/HR 5364, CHIP Extension and Improvement Act of 2014.

Client expense: $410,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R.5464 and draft Senate legislation, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division G, Title II Issues: Support funding for NIH, Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Children's Hospitals Graduate Medical Education program (CHGME), HRSA, biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Support emergency supplemental funding to prepare and respond to Ebola and to reimburse for Ebola Virus Disease treatment. H.R. 4486 and draft Senate legislation, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division I, Title II President's Budget, FY 2016 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Funding for Community Health Centers and the NHSC. Debt in Health Education Loan programs (DebtHELP) bill (draft) Issues: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction Act of 2013 Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. H.R. 487, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act, Sections 5503 and 5506 Issue: Redistribution of residency positions. Issue: Implementation of and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the Affordable Care Act. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform. Issue: Support the use of animals in medical research. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Implementation of Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose discretionary spending cuts through sequestration, including NIH, Titles VII and VIII health professions and nursing education programs, and other science programs. Issue: Support primary care workforce development S. 1759, Teaching Health Center Reauthorization Act Issue: Legislation to reauthorize the Teaching Health Center Program and payments. Issue: Draft legislation on pain education in undergraduate and graduate medical education. H.R.548/S. 1152, The Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 5294, Health Equity and Accountability Act of 2014 Issue: Support bill to improve health equity. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. H.R. 3698, Two Midnight Rule Delay Act of 2013 S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act. S. 2501, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. Issue: Educating health professionals regarding prescription drug abuse and appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Support ACA consumer outreach and enrollment efforts. Issue: Implementation of the 340B drug discount program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Support preservation of funding for the Primary Care Residency Expansion program. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 5411, Trafficking Awareness Training for Health Care Act of 2014 Issue: Medical education curricula content pertaining to human trafficking. S. 2658/H.R.5580, Accelerating Biomedical Research Act Issue: To increase discretionary spending cap to increase funding for the National Institutes of Health (NIH). S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act Issue: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. S. 2115, American Cures Act H.R. 4384, America HEALS ACT Issue: Support establishment of a fund to provide an expanded and sustained investment in biomedical research. H.R. 4879, Research for All Act Issues: Support inclusion of male and female cells, tissues and animals in basic biomedical research. Support update of NIH guidelines to increase participation of women in clinical trials. Issue: FDA regulation of Laboratory Developed Tests (LDTs) S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 2645, The Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids S. 2942, The Infectious Disease Hospitals Hubs Act Issue: Support legislation to establish a network of hospitals in preparing for and responding to infectious diseases. Issue: Support nomination of Dr. Vivek Murthy as U.S. Surgeon General Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: U.S. Census Bureau on the American Community Survey CMS on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program CMS on final rule regarding definition of uninsured for purposes of Medicaid DSH limits HHS on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.) FDA on strategies for increasing patient involvement in regulatory processes. White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. NIH in response to an RFI related to the development of grant program to help facilitate the transition from training to independence. NIH on the consideration of sex as a biological variable in biomedical research The Patient-Centered Outcomes Research Institute (PCORI) on the proposed process for peer review and public release of its primary research finding. DEA on delaying the Disposal of Controlled Substances Final Rule.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction of 2013. Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparency. Issue: Implementation and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Support Medicare physician payment reform. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. H.R. 487, Primary Care Workforce Access Improvement Act. Issue: Residency training in community-based settings. Issue: Primary Care Workforce Development. President's Budget, FY 2015 Issue: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 H.R. 3698, Two Midnight Rule Delay Act of 2013 Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act S. 2501, Hospital Readmission Accuracy and Accountability Act Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Issues: Support repeal of Medicares Sustainable Growth Rate (SGR) formula; Medicare physician payment reform. Issue: Draft legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Issue: Implementation of the 340B drug discount program. H.R. 4302, Protecting Access to Medicare Act of 2013. Issues: Support Medicare physician payment relief and extended delay of Medicare's "two-midnights" policy for hospital admissions; support the addition of GME language related to establishing Medicare caps and PRA; support delayed implementation of Medicaid DSH cuts. H.R. 4282, Creating Access to Residency Education Act of 2014 Issue: Create CMS grant program for new residency programs. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Support Medicaid expansion advocacy efforts. Issue: Draft legislation on pain education in undergraduate and graduate medical education. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 4942, Underserved Veterans Access to Health Care Act Issue: Increasing funding for VA GME and Medicare GME. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014. Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: Centers for Medicare & Medicaid Services (CMS) on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program. Centers for Medicare & Medicaid Services (CMS) on final rule regarding definition of uninsured for purposes of Medicaid DSH limits The Department of Health and Human Services (HHS) on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.)

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Legislative proposals affecting Medicare and Medicaid funding Proposed changes to Medicare hospital reimbursement policies Health Care Reform Implementation Graduate Medical Education - H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education, H.R. 1180 and S. 577, "Resident Physician Shortage Reduction Act of 2013" Proposed changes to Medicare hospital reimbursement policies H.R. 3698, "Two Midnight Rule Delay Act" S. 2082, "Two-Midnight Rule Coordination and Improvement Act of 2014" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, "Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments Medicare and Medicaid paymentMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/HR 1180 Resident Physician Shortage Reduction Act , all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/5.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule Issues related to admission and medical review criteria for inpatient services ("two midnights rule") S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act - all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act - all sections H.R. 4302 Protecting Access to Medicare Act - all sections H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act S. 1980 Medicaid and CHIP Continuous Quality Act H.R. 3678 Two-Midnight Rule Delay Act - all sections H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 2082 Two-Midnight Rule Coordination and Improvement Act S. 2501 Hospitals Readmissions Program Accuracy and Accountability Act, all sections Issues related to quality measures reporting in Medicaid S. 2461 CHIP Extension act of 2014, all provisions Issues related to Medicare payment for patients in "observation status" in hospitals CMS FY 2014 Outpatient Prospective Payment System Rule Issues related to Medicare Recovery Audit Contractors S. 2941 Medicare Protection Act, all Provisions Extension of SSA 1902 (a) (b) (c) - Medicaid Primary Care payment parity Childrens Health Insurance Program Medicare Hospital Re-admissions Program Meaningful Use Stage 2 H.R. 5481 The Flexibility in Health IT Reporting Act H.R. 5364 CHIP Extension and Improvement Act, All provisions Hospital Improvements for Payment Act of 2014 (generally and specific sections) Section 101: Hospital Prospective Payment System 102: Per Diem payment rate for short lengths of stay 103: Repeal of the Two- Midnights payment reduction 104 and 105: Monitoring performance of and improvements to the RAC program 109: Hospital assessment data 110: Cost information on hospital payments 201: Repeal of the moratorium on physician owned hospitals 214: Tennessee DSH allotment for FY2015 and succeeding fiscal years 216: NOTICE Act 217: Establishing equity in the Hospital Readmissions Program Act

Client expense: $240,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Medicaid funding for disproportionate share hospital; 340B drug discount program; S.2501 (the Hospital Readmission Program Accuracy and Accountability Act of 2014), regarding the hospital readmission program under Medicare; development of legislation to create partnership opportunities for essential hospitals.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid disproportionate share hospital cuts, including DSH Reduction Relief Act - support amendments to mitigate the impact of cuts on losing hospitals, postpone Medicaid DSH cuts; Graduate Medical Education issues (including Resident Physician Shortage Reduction Act (S.577/H.R.1180) - support; Amendments to the Medicare hospital readmissions penalty program methodology (providing SES adjustments, fixing the formula flaw), H.R.4188/S.2501 - support; IMPACT Act (S.2553/H.R.4994), support reducing burdensome hospital requirements in original bill; support of final bill; Medicare Audit Improvement Act (H.R.1250/S.1012) and other issues related Medicare claims appeal backlogs - support; Proposals to amend the 2 Midnight Policy (CMS-1599-F)(H.R. 3698/S.2082) - support; comments on House Ways and Means discussion draft legislation, Hospital Improvements for Payment Act of 2014, concerns about new proposed short stay payment methdology and impact on teaching hospitals; CMS Disallowance to NYS File No.:NY-2014-03-MAP - oppose, support NYS Congressional delegation letter to CMS; legislation to create a comprehensive Medicare home infusion benefit (H.R.5435) - support; comments on physician services pertaining to non-face-to-face chronic care management services (CMS-1612-P); support NYS Congressional delegation letter to CMS on NYS State plan amendments on Medicaid rates for hospitals (2% cut restoration, Vital Access Provider funds).

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), SENATE, White House Office

End-stage renal disease reimbursement and policies related to the Medicare End Stage Renal Disease Prospective Payment System; and issues related to state-based health insurance exchanges and patient protections for patients under the Affordable Care Act (Public Law 112-25). Final Regulations issued by CMS regading Medicare payments for services for people living with ESRD. Proposal at the Center for Medicare and Medicaid Innovation to develop a coordinated kidney care pilot program that would integrate care for Medicare beneficiaries with ESRD. CMS call letter for Medicare Advantage plans with a focus on rate setting and risk adjustment issues. H.R. 4814: The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014 (All provisions) CMS regulations related to the treatment of Medicare Part C and D. CMS regulations pretaining to reimbursement rates for ESRD-related services. S. 2501: Hospital Readmissions Program Accuracy and Accountability Act (All provisions) H.R. 5481: The Flexibility in Health IT Reporting Act of 2014 "Flex-IT Act" (All provisions)

Client expense: $1,000,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

End-stage renal disease reimbursement and policies related to the Medicare End Stage Renal Disease Prospective Payment System; and issues related to state-based health insurance exchanges and patient protections for patients under the Affordable Care Act (Public Law 112-25). Final Regulations issued by CMS regading Medicare payments for services for people living with ESRD. Proposal at the Center for Medicare and Medicaid Innovation to develop a coordinated kidney care pilot program that would integrate care for Medicare beneficiaries with ESRD. CMS call letter for Medicare Advantage plans with a focus on rate setting and risk adjustment issues. H.R. 4814: The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014 (All provisions) CMS regulations related to the treatment of Medicare Part C and D. CMS regulations pretaining to reimbursement rates for ESRD-related services. S. 2501: Hospital Readmissions Program Accuracy and Accountability Act (All provisions) H.R. 5380: Medicare Telehealth Parity Act of 2014 (All provisions)

Client expense: $1,000,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Sustainable growth rate formula (H.R. 4015, S. 2157) - Advocated for the repeal of the SGR formula for Medicare physician reimbursement during the lame duck session of Congress. Opposed including further cuts to hospital payments to offset the cost of such legislation. Ways and Means Committee Hospital Improvement for Payment Discussion Draft - Monitored and reviewed the introduction of draft legislation from the Ways and Means Committee impacting hospital policies. Supported proposals to place greater restrictions on Medicare recovery audit contractor activities (similar to H.R. 1250, and S. 1012). Supported provision to include sociodemographic considerations in the Hospital Readmissions Reduction Program (similar to H.R. 4188 & S. 2501). Reviewed and monitored proposals to modify hospital payment systems to more accurately pay for short-stay admissions and supported proposals to delay enforcement of CMS' "two-midnight rule". Opposed provision that would relax current restrictions on physician-owned hospitals.

Client expense: $40,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), SENATE

H.R.3698, Two-Midnight Rule Delay Act of 2013; S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014; H.R.1180/S.577, Resident Physician Shortage Reduction Act of 2013; H.R.4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act;S.2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014; Issues related to hospital and related provider reimbursement, disproportionate share hospitals, graduate medical education and delivery system reforms.

Client expense: Not reported · Firm income: $50,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

S.577/H.R.1180, Resident Physician Shortage Reduction Act of 2013. H.R.1201, Training Tomorrow's Doctors Today Act. H.R.3698, Two-Midnight Rule Delay Act of 2013/S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014. H.R.4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act.S.2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014. S.2553/H.R.4994, Improving Medicare Post-Acute Care Transformation Act of 2014. H.R.83, Consolidated and Further Continuing Appropriations Act, 2015. Medicare funding for graduate medical education. Medicare reimbursement for hospital outpatient services.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Two Midnight Rule (HR 3698 / S. 2082) Socioeconomic adjustment of the hospital readmission reduction program (H.R. 4188 / S. 2501) Medicare Audit Improvement Ace (H.R. 1250 / S. 1012) DSH Reduction Relief Act (H.R. 1920 / S. 1555)Sustainable Growth Rate Medical Liability Reform (S. 1769 / H.R. 1473, H.R. 36 / S. 961) Mental Health Policy (H.R. 3717) Rural Hospital Policies (H.R. 1787 /S. 842, H.R. 3991 / S. 2037, H.R. 3444, S. 2359, H.R. 2801 / S. 1143) Post Acute Care Policies (H.R. 4994) Graduate Medical Education (H.R. 1201 / S. 577 / H.R. 1180) Meaningful Use of Electronic Health Records (H.R. 5481) Children's Health Insurance Program Veterans Access to Care Nurse Education Policies 340B Drug Discount Program Home Health Face-To-Face Requirement FY 2015 IPPS

Client expense: $46,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated to support rural hospitals in CMS rulemaking Advocated for support of Medicaid Provider Assessment Advocated for modifying hospital readmissions policies - HR 4188 / S 2501 Advocated to delay 2 midnights rule - HR 3698 / S 2082 Advocated to support DSH hospitals - HR 1920 / S 1555 Advocated to modify Medicare audits - HR 1250 / S. 1012 Advocated for delay of implementation of DEA controlled substances final rule Advocated in support for ebola emergency funding

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4994 - The Impact Act of 2014 - Provisions in the legislation focused on developing quality measurements that account for socioeconomic status. H.R. 83- Consolidated and Further Continuing Appropriations Act of 2014 - Issues related to Medicare and Medicaid policy. S. 1871/S. 2157- Medicare SGR Repeal and Beneficiary Access Improvement Act - Focus on payment reform and particularly on the issues of measuring of low income socioeconomic status for the purposes of delivery system reform and reimbursement efforts. S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act - Focus on ensuring that hospitals that serve vulnerable populations are considered in the development of measures for quality. Issues related to training of physicians and other hospital and community- based health care professionals Issues related to Graduate Medical Education Regulations regarding Health Reform including the Navigator Program, Pioneer ACOs, and other innovation-focused programs being implemented by HHS. Issues related to the inclusion of socioeconomic status as a measurement for quality and performance. Efforts related to reforming the Sustained Growth Rate for physicians. Health-tax issues impacting not-for-profit hospitals. Issues related to the treatment of mental health issues in Medicare, Medicaid and CHIP. S. 1871/S. 2157- Medicare SGR Repeal and Beneficiary Access Improvement Act - Focus on payment reform and particularly on the issues of measuring of low income socioeconomic status for the purposes of delivery system reform and reimbursement efforts. S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act - Focus on ensuring that hospitals that serve vulnerable populations are considered in the development of measures for quality. Issues related to training of physicians and other hospital and community- based health care professionals Issues related to Graduate Medical Education Regulations regarding Health Reform including the Navigator Program, Pioneer ACOs, and other innovation-focused programs being implemented by HHS. Issues related to the inclusion of socioeconomic status as a measurement for quality and performance. Efforts related to reforming the Sustained Growth Rate for physicians. Health-tax issues impacting not-for-profit hospitals. Issues related to the treatment of mental health issues in Medicare, Medicaid and CHIP.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

H.R. 4994 - The Impact Act of 2014 - Provisions in the legislation focused on developing quality measurements that account for socioeconomic status. H.R. 83- Consolidated and Further Continuing Appropriations Act of 2014 - Issues related to Medicare and Medicaid policy. S. 1871/S. 2157- Medicare SGR Repeal and Beneficiary Access Improvement Act - Focus on payment reform and particularly on the issues of measuring of low income socioeconomic status for the purposes of delivery system reform and reimbursement efforts. S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act - Focus on ensuring that hospitals that serve vulnerable populations are considered in the development of measures for quality. Issues related to training of physicians and other hospital and community- based health care professionals Issues related to Graduate Medical Education Regulations regarding Health Reform including the Navigator Program, Pioneer ACOs, and other innovation-focused programs being implemented by HHS. Issues related to the inclusion of socioeconomic status as a measurement for quality and performance. Efforts related to reforming the Sustained Growth Rate for physicians. Health-tax issues impacting not-for-profit hospitals. Issues related to the treatment of mental health issues in Medicare, Medicaid and CHIP. S. 1871/S. 2157- Medicare SGR Repeal and Beneficiary Access Improvement Act - Focus on payment reform and particularly on the issues of measuring of low income socioeconomic status for the purposes of delivery system reform and reimbursement efforts. S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act - Focus on ensuring that hospitals that serve vulnerable populations are considered in the development of measures for quality. Issues related to training of physicians and other hospital and community- based health care professionals Issues related to Graduate Medical Education Regulations regarding Health Reform including the Navigator Program, Pioneer ACOs, and other innovation-focused programs being implemented by HHS. Issues related to the inclusion of socioeconomic status as a measurement for quality and performance. Efforts related to reforming the Sustained Growth Rate for physicians. Health-tax issues impacting not-for-profit hospitals. Issues related to the treatment of mental health issues in Medicare, Medicaid and CHIP.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188) Hospital Readmissions Program Accuracy and Accountability Act (S. 2501) Training Tomorrow's Doctors Today Act (H.R. 1180/H.R. 1201)To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes. (H.R. 5481)

Client expense: $12,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-Advocated in support of the Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R.4188) and its Senate companion legislation - the Hospital Readmissions Program Accuracy and Accountability Act of 2014 (S.2501) -Advocated for the delay of the Two-midnights rule through support of the Two-Midnight Rule Delay Act (H.R.3698) and its Senate companion legislation (S.2082) -Advocated in support of the Disproportional Share Hospital (DSH) Reduction Relief Act (H.R.1920) and its Senate companion legislation (S.1555) -Advocated in support of the Medicare Audit Improvement Act (H.R.1250) and its Senate companion legislation (S.1012) -Engaged in discussions regarding 21st Century Cures Initiative, which is designed to accelerate processes at the National Institutes of Health and Food and Drug Administration n order to improve drug and device processes, increase discovery, and improve delivery -Discussed Alzheimers Disease research efforts on campus -Discussed support for efforts at HRSA regarding cord blood banking

Client expense: $88,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961 Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins(R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

Client expense: $4,270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

H.R. 4930, the Advancing Care for Exceptional Kids Act - provisions related to Medicaid-eligible children with medically complex needs Issues related to the CMS Medicare wage index H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmission Program Act - provisions related to accounting for socio-economic status for purposes of Medicares Hospital Readmission Reduction Program S. 2501, the Hospital Readmissions Program Accuracy and Accountability Act - provisions related to accounting for socio-economic status for purposes of Medicares Hospital Readmission Reduction Program General issues related to the outlook for SGR reform Issues related to Graduate Medical Education (GME)

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for fairness in Medicare Advantage Stars Quality measurements; opposed cuts to Medicare Advantage rates; S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014; H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act; H.R. 5183, VBID for Better Care Act of 2014.

Client expense: $330,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid funding Proposed changes to Medicare hospital reimbursement policies Health Care Reform Implementation Graduate Medical Education - H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1920, S. 1555, DSH Reduction Relief Act of 2013, Issues regarding delaying implementation of DSH cuts. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. Issues pertaining to offsets for SGR patch. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient disparities/socioeconomic status.

Client expense: $100,000 · Firm income: Not reported

Government targets: Economic Development Administration, HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education, H.R. 1180 and S. 577, "Resident Physician Shortage Reduction Act of 2013" Proposed changes to Medicare hospital reimbursement policies H.R. 3698, "Two Midnight Rule Delay Act" S. 2082, "Two-Midnight Rule Coordination and Improvement Act of 2014" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 S. 2501, Hospital Readmission Accountability and Improvement Act

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, "Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

End-stage renal disease reimbursement and policies related to the Medicare End Stage Renal Disease Prospective Payment System; and issues related to state-based health insurance exchanges and patient protections for patients under the Affordable Care Act (Public Law 112-25). Final Regulations issued by CMS regading Medicare payments for services for people living with ESRD. Proposal at the Center for Medicare and Medicaid Innovation to develop a coordinated kidney care pilot program that would integrate care for Medicare beneficiaries with ESRD. CMS call letter for Medicare Advantage plans with a focus on rate setting and risk adjustment issues. HR 4814 The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014. CMS regulations related to the treatment of Medicare Part C and D. CMS regulations pretaining to reimbursement rates for ESRD-related services. S. 2501 Hospital Readmissions Program Accuracy and Accountability Act.

Client expense: $840,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

End-stage renal disease reimbursement and policies related to the Medicare End Stage Renal Disease Prospective Payment System; and issues related to state-based health insurance exchanges and patient protections for patients under the Affordable Care Act (Public Law 112-25). Final Regulations issued by CMS regading Medicare payments for services for people living with ESRD. Proposal at the Center for Medicare and Medicaid Innovation to develop a coordinated kidney care pilot program that would integrate care for Medicare beneficiaries with ESRD. CMS call letter for Medicare Advantage plans with a focus on rate setting and risk adjustment issues. HR 4814 The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014. CMS regulations related to the treatment of Medicare Part C and D. CMS regulations pretaining to reimbursement rates for ESRD-related services. S. 2501 Hospital Readmissions Program Accuracy and Accountability Act.

Client expense: $840,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

HR3590 PL No. 111-148 Patient Protection and Affordable Care Act HR4302 PL No. 113-93 Protecting Access to Medicare Act of 2014 HR1250 Medicare Audit Improvement Act of 2013 HR4188 Establishing beneficiary equity in the hospital readmission program act of 2014 S2501 Hospital Readmissions Program Accuracy and Accountability Act

Client expense: $140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE